Request a Poverty Simulation

Name of organization requesting the Poverty Simulation
Name of primary contact person
Phone number for primary contact person Phone number for primary contact person - ### - ### ####
Email address for primary contact person
Physical address for the requesting organization Physical address for the requesting organization
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Where would you like the poverty simulation to be held? (Town/City)
What counties/regions in Oklahoma does your organization serve?

What counties/regions in Oklahoma does your organization serve? Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love Major Marshall Mayes McClain McCurtain McIntosh Murray Muskogee Noble Nowata Okfuskee Oklahoma Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward NE District NE Area West District SE District
Preferred dates/time frame for the simulation

(please understand that we cannot always guarantee to have a full team available for specific dates):
First Choice
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Date Date / MM / DD YYYY
Time Time : HH MM AM/PM
Second Choice
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Date Date / MM / DD YYYY
Time Time : HH MM AM/PM
Third Choice
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Date Date / MM / DD YYYY
Time Time : HH MM AM/PM
A poverty simulation is a large undertaking for both the requesting agency and OSU Extension. We ask that you read through and check the following statements of understanding as a way to prepare your organization for the responsibilities associated with hosting a poverty simulation.
I understand that…

I understand that… the minimum number of participants for a small simulation is 40 and I further understand that my organization is responsible for securing this minimum number of participants. the maximum number of participants for a large simulation is 80. my organization will be expected to secure 20 volunteers to assist with the simulation. all participants and volunteers must be at least 18 years of age. it is the responsibility of my organization to market/publicize the simulation in the community in order to recruit participants and volunteers. the final participation numbers for the simulation should be confirmed to OCES no later than one week prior to the event. my organization must secure a location for the simulation and I further understand that the facility must include a large space minimum 3,000 square feet (such as a gymnasium) AND a classroom large enough to accommodate the anticipated number of attendees. my organization will secure/provide 175 chairs and 15 tables for the simulation plus 2 tables for registration and family role assignments. the facility must be available for 2 consecutive days including the full day of the event (morning and afternoon) and the afternoon prior to the event for room set-up. my organization is responsible for setting up the facility according to the floor plan which will be provided by OCES. any food or refreshments provided at the poverty simulation will be provided my organization. OCES is not responsible for the provision of food or refreshments. the facilitation of a poverty simulation requires a team of trained facilitators from OSU Extension and that it may not be possible to secure the full team on my preferred date(s). a representative of my organization will be asked to sign a Memorandum of Understanding outlining the understandings stipulated above.

Request a Poverty Simulation

Preferred dates/time frame for the simulation

First Choice----------------------------------------------------------

Second Choice----------------------------------------------------------

Third Choice----------------------------------------------------------

A poverty simulation is a large undertaking for both the requesting agency and OSU Extension. We ask that you read through and check the following statements of understanding as a way to prepare your organization for the responsibilities associated with hosting a poverty simulation.

First Choice
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Second Choice
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Third Choice
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